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General NPI Number Information
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NPI Number | 1447995766
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Entity Type | Organization
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Legal Business Name | MERCYONE URGENTCARE
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 2400 LILLIAN WAY
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City | CLINTON
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State | IA
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Zip | 52732-2001
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Country | US
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Telephone | 563-559-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 10319 JEFFERSON HWY
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City | BATON ROUGE
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State | LA
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Zip | 70809-2730
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP REVENUE CYCLE
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Name | TAMARA SAMSON
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Credential |
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Telephone | 225-214-1031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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